News: Suspension of two-midnight rule reviews could last through July

A temporary suspension of initial reviews for Medicare reimbursement of short-term patient stays in hospitals could stretch through the end of July, a CMS spokesperson said Tuesday. Two companies have been contracted to conduct the reviews: Annapolis Junction, MD-based Livanta and Harrisburg, PA-based KEPRO.

In the latest twist of the two-midnight rule's course toward full implementation, CMS told government contractors early last month to suspend initial reviews of Medicare claims for inpatient stays shorter than a span of two midnights.

Under the rule, which has been in place since October 2013 and was significantly revised in October 2015, most hospital stays spanning a period of less than two midnights are considered inappropriate for designation as inpatient status and are ineligible for reimbursement.

Last October, CMS announced that initial two-midnight rule reviews would be shifted from Recovery Audit Contractors to Beneficiary and Family Centered Care-Quality Improvement Organizations (BFCC-QIOs).

Editor’s note: This article was originally published by HealthLeaders Media.